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Abdominal Aortic Aneurysm (AAA) - Causes, Symptoms, Diagnosis, Treatment, Risk Factors and Complications

Published on Apr 19, 2022 and last reviewed on Jan 10, 2023   -  5 min read

Abstract

An abdominal aortic aneurysm is a vascular condition characterized by a bulge in the aorta present in the abdominal region. Read the article to know more.

What Is an Abdominal Aortic Aneurysm (AAA)?

The abdominal aortic aneurysm (AAA) is a bulge and swelling in the lower part of the aorta located in the abdomen. The bulging in the lower part of the aorta is due to the weakening of the vessel. An abdominal aortic aneurysm is an expanded area in the lower part of the central vessel that provides blood to the body (aorta).

An abdominal aortic aneurysm is dangerous, but the outcome is favorable for fixed aneurysms. The death rate is above 50 percent for a ruptured aneurysm. Aneurysms can occur in any region of the aorta, but the abdomen is the most frequent site. Entire abdominal aortic aneurysms (AAAs) usually cause no health problems. However, large AAAs can break or rupture and generate heavy bleeding in the abdomen.

AAA

What Are the Causes of an Abdominal Aortic Aneurysm (AAA)?

The exact cause of an aneurysm is not known. It happens due to a defect in the wall of the artery. Other causes of AAA include trauma, infection, arteritis, and medial cystic necrosis.

Other causative factors that elevate your chances of having this problem include:

What Can Be the Signs and Symptoms of an Abdominal Aortic Aneurysm (AAA)?

An enlarged abdominal aortic aneurysm can cause deep, constant pain in the abdomen or on the side of the stomach, back pain, and a pulse near the belly button. Usually, there will not be any symptoms, but the aneurysm will get bigger and pressure the surrounding organs.

The most usual sign is common belly pain or discomfort, which may come and be persistent. The other symptoms may include:

  • Pain in the chest, lower back, belly (abdomen), or flank (over the kidneys) that may radiate to the groin, buttocks, or legs. The pain may be deep, gnawing, aching, or throbbing, and it may persist for hours or days. It is generally not changed by movement. But particular positions may be more convenient than others.

  • A pulsating sensation in the belly.

  • A cold foot or a blue or black painful toe. This can happen if an aneurysm creates a blood clot that breaks off and obstructs blood flow to the legs or feet.

  • Fever or weight loss can occur if the aneurysm is caused by infection or inflammation.

If an aortic aneurysm ruptures, it can lead to sudden or severe pain, an extreme drop in blood pressure, and signs of shock. Without prompt treatment, it can soon lead to death.

How to Diagnose Abdominal Aortic Aneurysm (AAA)?

Most abdominal aortic aneurysms are detected unexpectedly during general physical examination or when abdominal ultrasonography, CT (computed tomography), or MRI (magnetic resonance imaging) is performed for different reasons. An AAA should be analyzed in older patients who have acute abdominal or back pain whether there is any palpable pulsatile growth or not.

How to Treat an Abdominal Aortic Aneurysm (AAA)?

The treatment options for asymptomatic AAA are conservative management, surveillance with a view to eventual repair, and immediate repair.

There are two modes of repair available for an AAA:

  1. Open aneurysm repair.

  2. Endovascular aneurysm repair.

An intervention is often suggested if the aneurysm grows more than 1 centimeter per year or more prominent than 5.5 cm. Repair is also intimated for symptomatic aneurysms. In those with aortic rupture of the AAA, treatment is urgent surgical repair. There appear to be advantages in allowing permissive hypotension and restricting intravenous fluids while being transported to the operating room.

Medication:

No medical therapy is effective in reducing the growth rate or rupture rate of asymptomatic AAAs. Blood pressure and lipids should, however, be managed as usual.

Surgery:

Repair is generally suggested if the aneurysm is 1.9 to 2.2 inches (4.8 to 5.6 centimeters), more significant, or increasing. The doctor might also recommend surgery if the patient has symptoms of stomach pain or a tender, leaking, or painful aneurysm. Depending upon the several factors, like location and size of the aneurysm, age, and other conditions, repair options might include:

  • Open repair involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft) sewn into place.

  • Endovascular repair has less invasive procedures; therefore, it is commonly used. The doctors may attach a synthetic graft at the end of a thin tube (catheter) injected into an artery in the leg and joined into the aorta.

  • The graft, such as a woven tube covered by a metal mesh support, is placed at the aneurysm site, expanded, and joined. It strengthens the weakened section of the aorta to stop the rupture of the aneurysm.

What Are the Risk Factors for Abdominal Aortic Aneurysm (AAA)?

The risk factors for an abdominal aortic aneurysm are:

  • Tobacco Use: Smoking is the most potent risk factor, which can weaken the aortic walls, increasing the risk of acquiring an aortic aneurysm and may rupture. The longer the smoking and chewing of tobacco, the higher the chances of developing an aortic aneurysm.

  • Age: These aneurysms happen most frequently in people of age 65 and older.

  • Male: Abdominal aortic aneurysms are more common in men than in women.

  • White People: People who are white are at greater risk of acquiring the disease.

  • Family History: A family history of abdominal aortic aneurysms raises the risk of acquiring the condition.

  • Aneurysm in Another Blood Vessel: Having an aneurysm in another larger blood vessel, such as the artery behind the knee or the aorta in the chest, might increase the risk of an abdominal aortic aneurysm.

An abdominal aortic aneurysm is most frequently seen in males over age 60 who possess one or more risk factors. The larger the aneurysm, the more prone it is to break open or tear. This can be a life-threatening condition.

What Can Be the Complications of an Abdominal Aortic Aneurysm (AAA)?

Tears in one or more of the aorta wall layers or a ruptured aneurysm are the main complications. A rupture can induce life-threatening internal bleeding. In general, the bigger the aneurysm and the quicker it grows, the greater the risk of rupture. A ruptured aneurysm can cause sudden, sharp, and persistent abdominal or back pain, which can be defined as a tearing sensation, low blood pressure, and fast pulse. Aortic aneurysms also put a person at risk of forming blood clots in the area. If a blood clot detaches from an aneurysm inside the wall, it can block a blood vessel elsewhere in your body, causing pain or blocking the blood flow to the legs, toes, kidneys, or abdominal organs.

How to Prevent Abdominal Aortic Aneurysms (AAA)?

To prevent an aortic aneurysm or stop it from getting worse, do the following:

  • Quit habits like smoking or chewing tobacco and avoid secondhand smoke.

  • Follow a healthy diet like eating a variety of fruits, vegetables, whole grains, poultry, fish, and low-fat dairy products.

  • Avoid saturated fat and trans fats and limit salt.

  • Keep the blood pressure and cholesterol level under control. Take the medicines prescribed by the doctor regularly.

  • Get regular exercise, at least 150 minutes a week of moderate aerobic workouts.

Conclusion:

An abdominal aortic aneurysm is a condition that might require immediate medical attention, especially in cases where there is a larger aneurysm to avoid rupture. As far as management and prevention are concerned, maintaining a healthy lifestyle can bring about positive impacts. For more information consult a specialist online at iCliniq.com.

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Frequently Asked Questions


1.

What Is an Abdominal Aortic Aneurysm?

The aorta is the largest blood vessel in the heart that supplies blood to the whole body. It runs through the chest and the abdomen. When the aortic walls get weakened, they can bulge. This enlarged area in the lower part of the aorta is called the abdominal aortic aneurysm.

2.

How Serious Is an Abdominal Aortic Aneurysm?

The abdominal aortic aneurysm is a severe condition because the people who have them may go in for something completely unrelated. They will go for testing like an X-ray, ultrasound, or CT (computed tomography) scan, and the aneurysm may become bigger by that time. Unfortunately, it might be too late because people will become symptomatic only when it actively grows or ruptures. When left untreated, people will get:
- Life-threatening internal bleeding due to a tear in the walls of the aorta.
- Formation of a blood clot that can break off and block the blood vessel anywhere else in the body.
- An abnormal connection between the vein and the aorta (fistula).
- A ruptured aneurysm (fatal event).

3.

What Is the Causative Factor of Abdominal Aortic Aneurysm?

An abdominal aortic aneurysm can be caused by:
- High blood pressure.
- Diseases of the blood vessels.
- Hardening of the arteries.
- Trauma due to a road accident.
- Infections (bacterial or fungal) in the aorta.

4.

How Is a Screening Test Done for Abdominal Aortic Aneurysm?

The screening of AAA is done to check whether there is a bulge in the aorta. An abdominal aortic aneurysm is a silent killer because people do not know they have them. It is diagnosed incidentally. The screening involves reviewing personal and family medical history and conducting a physical examination followed by a specialized test for AAA. A typical AAA may grow in small increments over the years, which is very important about the screening. The standard tests done for AAA involve ultrasound, CT scan, and MRI (magnetic resonance imaging), which is done to measure the width of the aorta. The screening for AAA is painless, and people can get it done in the radiology clinic.

5.

What Happens to the Body When an Abdominal Aortic Aneurysm Bursts?

A ruptured or burst AAA can cause life-threatening internal bleeding. Unfortunately, the majority of the people who undergo rupturing of the AAA will die before they reach the hospital or may not survive the surgery.

6.

What Are the Symptoms of Abdominal Aortic Aneurysm?

People with AAA will become symptomatic only when the disease actively grows or ruptures. A few people may experience symptoms like:
- Back pain.
- Pulsating feeling near the navel.
- Nausea and vomiting.
- Sensitivity to light.
- Blurred or double vision.
- Seizure.
- A drooping eyelid.
- Stiff neck.
- Loss of consciousness.
- A cold foot or a blue or black painful toe.
- Deep constant pain in the abdomen.
- Severe pain in the abdomen when it ruptures.

7.

How Long Does It Take To Perform an Abdominal Aortic Aneurysm Surgery?

The time taken to repair an abdominal aortic aneurysm is around two hours to three hours, depending on the severity of the disease condition.

8.

At What Size Is an Abdominal Aortic Aneurysm Considered to Be Dangerous?

The larger the aneurysm, the higher the risk of rupturing. For example, an aneurysm more than 5 cm in size has the chance of rupturing within one year in a few people, and it is considered dangerous.

9.

What Type of Exercise or Lifting Should Be Avoided in Abdominal Aortic Aneurysms?

Patients with abdominal aortic aneurysms should avoid exercises like the Valsalva maneuver and weight lifting to avoid rupturing of the aorta. But, low-intensity exercises like brisk walking and light aerobic exercises can be done to keep the blood pressure in control.

10.

How Common Is an Abdominal Aortic Aneurysm?

AAA commonly occurs in males above the age of 60. It starts at the age of 50 and goes to its peak by 80. Women are less commonly affected than men. Africans are less commonly affected than Caucasians.

11.

What Is the Survival Rate in a Patient With an Abdominal Aortic Aneurysm?

The survival rate of AAA in a non-operated patient is about 20 percent. The risk of rupture depends on the increase in the size of the aneurysm. When the aneurysm is more than 6 cm, the risk of rupture is very high. In a ruptured aneurysm, the risk of death is about 80 percent. Therefore, most people die before they reach the hospital. The survival rate in a surgically treated AAA patient depends on the age at which it is repaired and the size of the aneurysm.

12.

How to Identify if You Have an Aneurysm in Your Stomach?

A few symptoms that can help to identify that you have an aneurysm in your stomach are:
- Pain in the abdomen.
- Pain in the lower back that extends into the groin and legs.
- A feeling of a throbbing lump in the abdomen.
- Weight loss.
- Loss of appetite.

13.

What Are the Foods to Be Avoided if You Have an Aortic Aneurysm?

Patients with an aortic aneurysm should avoid foods containing high cholesterol like fatty meat, fatty dairy products like milk, fatty oils, margarine, cheese, deep-fried fast foods, butter, and other foods like white carbohydrates, sugary drinks, colas, and sodas.

14.

Will the Patient With an Abdominal Aortic Aneurysm Get Bowel Problems?

Due to the occlusion of the superior mesenteric artery, the bowel, which receives the reduced blood flow, will lose its absorptive function where the small intestine cannot absorb enough of certain nutrients and fluids from the food.

15.

What Are the Things to Be Avoided if You Have an Aortic Aneurysm?

The things to be avoided if you have an abdominal aneurysm include:
- Smoking.
- Stress.
- Exercises that increase the intra-abdominal pressure.
- Lifting heavyweights.
- Doing sit-ups.
- Forceful straining on the toilet.

16.

Is It Advisable to Take Ibuprofen for an Aortic Aneurysm?

It is not safe to take Ibuprofen when you have an aortic aneurysm because dissection is found in people who take Ibuprofen, especially in males above 60 years who took the drug for more than one month.

17.

Can an Abdominal Aneurysm Heal on Its Own?

A large abdominal aneurysm will not heal on its own, and it requires repair to prevent it from rupturing. Surgery involves the replacement of the aneurysm with an artificial graft. There are two types of surgery for abdominal aortic aneurysms: open surgery and endovascular surgery. However, either of them can be done to repair abdominal aortic aneurysms.

Last reviewed at:
10 Jan 2023  -  5 min read

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